A nurse is teaching a client who is preoperative for a neobladder urinary diversion.
Which of the following statements should the nurse make?
You will have an internal pouch to store your urine.
You will not be able to control your urination.
You will have a stoma that is located in your abdomen.
You will wear an external collection bag to drain your urine.
The Correct Answer is A
Choice A rationale
Neobladder urinary diversion involves creating an internal reservoir or pouch from a segment of the intestine to store urine. This new bladder is then connected to the urethra,
enabling the client to void through the urethra. This method closely mimics natural urination, allowing the client to have some control over urination.
Choice B rationale
This is incorrect because a neobladder is designed to allow the client to control urination. While there might be a learning curve for the client to adapt to the new bladder, the ultimate
goal is to achieve continence.
Choice C rationale
This describes an ileal conduit, another type of urinary diversion, where a stoma is created on the abdomen for urine to pass into an external bag. The neobladder does not involve a
stoma for urination.
Choice D rationale
This is incorrect as it pertains to an ileal conduit or urostomy. Clients with a neobladder do not require an external collection bag since urine is stored internally in the constructed
bladder and can be passed through the urethra. .
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Correct Answer is C
Explanation
Choice A rationale
Toxic levels refer to concentrations of a medication that are high enough to cause harmful effects or poisoning. This is not related to the lowest serum concentration.
Choice B rationale
Peak levels are the highest concentration of a medication in the bloodstream after administration. This occurs after the drug is absorbed and distributed.
Choice C rationale
Trough levels occur when the medication is at its lowest concentration in the bloodstream, typically just before the next dose is due. Monitoring trough levels helps ensure therapeutic effectiveness while avoiding toxicity.
Choice D rationale
Half-life refers to the time it takes for the concentration of a drug in the bloodstream to decrease by half. It is not directly related to the lowest serum concentration at a specific point in time.
Correct Answer is B
Explanation
Choice A rationale
Placing the client into a right lateral position is not the standard position for administering an enema. The left lateral (Sims') position is commonly used as it facilitates the flow of the
solution into the colon.
Choice B rationale
Warming the enema solution to room temperature helps ensure the client's comfort and can prevent cramping and discomfort. Cold solutions can cause discomfort and cramping,
making the procedure less tolerable for the client.
Choice C rationale
Sterile technique is not required for administering an enema. Clean technique is generally sufficient unless otherwise indicated by the client’s condition or specific medical orders.
Choice D rationale
Lubricating the tubing is essential to ensure smooth insertion and prevent trauma to the rectal mucosa, but an oil-based lubricant is not typically used as it can interfere with the
absorption of the enema solution. Water-soluble lubricants are preferred.